{extend name="public/layer_base"}

{block name="main"}
<form action="?" method="post" class="form form-horizontal" id="form-send">
    <div class="row cl">
        <label class="form-label col-xs-4 col-sm-2"><span class="c-red">*</span>用户名：</label>
        <div class="formControls col-xs-8 col-sm-9">
            <input type="text" class="input-text" name="username" value="{$data.username|default=''}">
        </div>
    </div>
    <div class="row cl">
        <label class="form-label col-xs-4 col-sm-2"><span class="c-red">*</span>密码：</label>
        <div class="formControls col-xs-8 col-sm-9">
            <input type="password" class="input-text" name="password"  value="">
        </div>
    </div>
    <div class="row cl">
        <label class="form-label col-xs-4 col-sm-2"><span class="c-red">*</span>确认密码：</label>
        <div class="formControls col-xs-8 col-sm-9">
            <input type="password" class="input-text" name="repassword" value="">
        </div>
    </div>
    <div class="row cl">
        <label class="form-label col-xs-4 col-sm-2"></label>
        <div class="formControls col-xs-8 col-sm-9">
            <p class="c-warning">{$data.id|default=0 > 0 ? '不填则不修改密码' : ''}</p>
        </div>
    </div>
    <div class="row cl">
        <label class="form-label col-xs-4 col-sm-2"><span class="c-red">*</span>邮箱：</label>
        <div class="formControls col-xs-8 col-sm-9">
            <input type="text" class="input-text" name="email" value="{$data.email|default=''}">
        </div>
    </div>
    <div class="row cl">
        <label class="form-label col-xs-4 col-sm-2"><span class="c-red">*</span>手机号码：</label>
        <div class="formControls col-xs-8 col-sm-9">
            <input type="text" class="input-text" name="mobile" value="{$data.mobile|default=''}">
        </div>
    </div>
    <div class="row cl">
        <label class="form-label col-xs-4 col-sm-2">角色：</label>
        <div class="formControls col-xs-8 col-sm-9">
            <span class="select-box" style="width:150px;">
				<select class="select" name="admin_role" size="1">
                    <option value="0">请选择</option>
                    {volist name="role_list" id="vo"}
                    <option value="{$vo.id}" {eq name="vo.id" value="$data->AdminJurisdiction->jurisdiction_group_id|default=0"} selected {/eq}>{$vo.name}</option>
                    {/volist}
                </select>
            </span>
        </div>
    </div>
    <div class="row cl">
        <div class="col-xs-8 col-sm-9 col-xs-offset-4 col-sm-offset-2">
            <button class="btn btn-primary radius" type="submit"><i class="Hui-iconfont">&#xe632;</i> 保存并提交审核</button>
            <button onClick="layer_close();" class="btn btn-default radius" type="button">&nbsp;&nbsp;取消&nbsp;&nbsp;</button>
        </div>
    </div>
    <input type="hidden" name="id" value="{$data.id|default=0}">
    <input type="hidden" name="__token__" value="{$Request.token}" />
</form>
{/block}